Table of Contents
Introduction
Shoulder impingement, often called swimmer’s shoulder, occurs when the tendons or bursa in the shoulder become irritated from repeated overhead motion. This is common in swimmers, athletes, and people who perform frequent lifting or reaching. With early treatment, most people can restore comfortable, pain-free movement.
What is Shoulder Impingement?
Shoulder impingement happens when the rotator cuff tendons or the bursa become pinched between the bones of the shoulder during movement. This repeated pinching leads to pain, inflammation, and weakness, especially when lifting the arm overhead or reaching behind the back. If left untreated, impingement may progress to bursitis or a rotator cuff tear.
What is the Subacromial Space?
The subacromial space is the small area between the acromion (the top part of the shoulder blade) and the rotator cuff tendons. When this space becomes narrowed due to swelling, tightness, or bone shape, the tendons and bursa can rub or become compressed. Keeping this space open is essential for smooth, pain-free shoulder motion.
Treatments for Shoulder Impingement
- Rest and activity modification: Avoid painful overhead motions or repetitive lifting.
- Physical therapy: A key part of treatment. Exercises focus on strengthening the rotator cuff, improving posture, and restoring normal shoulder mechanics.
- Anti-inflammatory medications: Help reduce pain and swelling.
- Ice or heat therapy: Provides relief and reduces irritation.
- Corticosteroid injections: Used when pain does not improve with initial treatments. They help reduce inflammation in the subacromial space.
Do I Need Surgery?
Most people recover without surgery. Surgery may be recommended if symptoms persist despite consistent therapy or if imaging shows a structural problem that narrows the subacromial space. Surgical procedures aim to remove inflamed tissue or create more room for the tendons to move freely.
Recovery and Rehabilitation
Recovery depends on the severity of the impingement and how quickly treatment begins. Physical therapy plays a major role in restoring strength, flexibility, and proper shoulder movement. Many people return to normal activities within a few weeks to a few months. Athletes may need sport-specific rehabilitation before returning to full activity.
References
Harrison AK, Flatow EL. Subacromial Impingement Syndrome. J Am Acad Orthop Surg. 2011;19(11):701-708. doi:10.5435/00124635-201111000-00006.
Morrison DS, Frogameni AD, Woodworth P. Non-Operative Treatment of Subacromial Impingement Syndrome. J Bone Joint Surg Am. 1997;79(5):732-737. doi:10.2106/00004623-199705000-00013.
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